Now it’s my turn to ask a question. Do you tell your doctor the truth about everything?
When you go see a medical provider there are certain standard questions you are likely to be asked. These include questions about whether you have chronic health conditions, take medications, use tobacco, alcohol or drugs and whether and with whom you have sex. Some of this is pretty personal stuff. Many people are tempted to be less than fully honest, with reasons that range from fear of judgment to none of your dang business. Some people even worry we’ll call the police on them if we find out they are breaking the law, or tell their parents things they don’t want their parents to know.
First of all, doctors are not cops. We have no obligation, indeed no right, to rat you out if you break the law. Not only that, we have no interest in doing so, with important exceptions I’ll explain below. Furthermore, what you tell us is confidential, which means that only people who take care of you can know it. By this I mean people who take care of you medically. This does not include your mother, your boyfriend or your professor.
If you tell your doctor that you drink alcohol underage, or smoke marijuana, or use other drugs, that information goes no further. If you disclose that you have multiple sexual partners, or unusual appetites or behaviors, same deal. That said, we will take your disclosures into consideration along with all of the information you give us about your health, and our findings on physical exam and testing, and do our best to advise you so that you stay as healthy as possible.
It is not our job to judge. In fact, it is our job not to judge.
But it is our job to help you get and stay healthy, and we can’t do that with partial information.
Here’s an example. You come in feeling short of breath with a heart rate well above normal. When I ask you about stimulants you don’t tell me about the workout supplement you have been taking three times a day, because you know you’re not supposed to take it that often, and you don’t think it is relevant. So I might end up doing expensive testing on your heart and sending you to a cardiologist, who would do more expensive testing.
But if you had just told me the truth, we could have avoided all that. I would probably have advised you to back off the supplement and come back for a recheck and chances are you’d be fine.
I encourage you to be frank, and not only because it makes my job easier. Your own needs will be better served if you come clean with yourself and your provider. If you are doing something unhealthy, you can’t make a change until you acknowledge what you are doing. The next step is to forgive yourself, by the way.
Everyone has bad habits, and beating yourself up is no way to prepare for change. But that is a topic for another article.
Again, what happens in the exam room stays, well, in your medical record. That is confidential information, protected by law and released only with your permission to people beyond your health care team.
Most parents are respectful of the boundaries around their adult child’s medical issues, but every so often one will call us up, demanding information. We politely decline, recommending they talk directly to their son or daughter. If you want your parent to be informed, you can let us know, but unless you do, mum’s the word, yes, even if they pay your bills.
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If a professor calls us up — and this has happened too — and wants to know if you are really sick or just ditching class, we don’t talk to them either. If you need one, ask us for a written class excuse to take to your professor and that should be enough.
One important exception is if we think you are in serious danger or putting someone else in serious danger. If you are suicidal, we can legally tell whoever we think we need to in order to keep you safe. This can include your family and the police. If we believe you are planning serious harm to someone else, same deal.
Short of these rare exceptions, your health is your business, shared with those who are trained to help you. I hope you will trust us with your truth.
